Iindidi / i-pancreatic / isigulana / unyango lwepancreatic-pdq

Unyango lwePancreatic Cancer (yabantu abadala) (®) -Patient Version

Ulwazi ngokubanzi malunga noMhlaza wePancreatic

IINGONGOMA EZIPHAMBILI

• Umhlaza wepancreatic sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicwili zepancreas.

• Ukutshaya kunye nembali yezempilo inokuchaphazela umngcipheko womhlaza wepancreatic.

• Iimpawu kunye neempawu zomhlaza wepancreatic zibandakanya i-jaundice, iintlungu, kunye nokwehla kobunzima.

• Umhlaza wepancreatic kunzima ukuwuchonga kwangoko.

• Uvavanyo oluvavanya iipancreas lusetyenziselwa ukufumanisa isifo somhlaza wepancreatic.

• Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Umhlaza wepancreatic sisifo apho iiseli ezibi (zomhlaza) zeeseli zenzeka kwizicwili zepancreas.

Ipancreas yidlala elimalunga nee-intshi ezi-6 ubude nelimile okweeperile ebhityileyo elele ngecala. Isiphelo ebanzi sepancreas kuthiwa yintloko, icandelo eliphakathi libizwa ngokuba ngumzimba, kwaye isiphelo esimxinwa sibizwa ngokuba ngumsila. Ipancreas ilele phakathi kwesisu kunye nomqolo.

I-Anatomy yepancreas. Ipancreas ineendawo ezintathu: intloko, umzimba, kunye nomsila. Ifunyanwa esiswini kufutshane nesisu, amathumbu, kunye namanye amalungu.

Ipancreas inemisebenzi emibini ephambili emzimbeni:

• Ukwenza iijusi ezincedisa ukwetyisa (ukwahlula) ukutya.

• Ukwenza iihomoni, ezinje nge-insulin kunye neglucagon, ezinceda ukulawula amanqanaba eswekile yegazi. Zombini ezi hormone zinceda umzimba ukuba usebenzise kwaye ugcine amandla owafumanayo ekutyeni.

Ijusi yokwetyisa yenziwa ziiseli zepancreas zangaphandle kunye neehomoni zenziwa ziiseli zepancreas ze-endocrine. Malunga ne-95% yomhlaza wepancreatic uqala kwiiseli zangaphandle.

Esi sishwankathelo malunga nomhlaza wepancreatic cancer. Ngolwazi malunga nomhlaza wepancreatic endocrine, jonga isishwankathelo se- kunyango lwePancreatic Neuroendocrine Tumors (Islet Cell Tumors).

Ngolwazi malunga nomhlaza wepancreatic ebantwaneni, jonga isishwankathelo se- soNyango lweCancreatic Cancer Treatment.

Ukutshaya kunye nembali yezempilo inokuchaphazela umngcipheko womhlaza wepancreatic.

Nantoni na eyandisa umngcipheko wokufumana isifo ibizwa ngokuba yingozi. Ukuba nomngcipheko akuthethi ukuba uza kuba nomhlaza; ukungabinamngcipheko oko akuthethi ukuba awuzukufumana umhlaza. Thetha nogqirha wakho ukuba ucinga ukuba usengozini.

Imingcipheko yomhlaza wepancreatic ibandakanya oku kulandelayo:

• Ukutshaya.

• Ukutyeba kakhulu.

• Ukuba nembali yobuqu yeswekile okanye ukunganyangeki okungapheliyo.

• Ukuba nembali yosapho yomhlaza wepancreatic okanye ipancreatitis.

• Ukuba neemeko ezithile zofuzo, ezinje:

• Uhlobo lwe-endocrine neoplasia yohlobo 1 (MEN1) yesifo.

• Umhlaza we-nonpolyposis colon umhlaza (HNPCC; Lynch syndrome).

• Isifo sikaV von Hippel-Lindau.

• Isifo sePeutz-Jeghers.

• Isifuba esifa kunye nesifo somhlaza we-ovari.

• Ulwalamano oluqhelekileyo lwe-molean melanoma (FAMMM) yesifo.

• Ataxia-telangiectasia.

Iimpawu kunye neempawu zomhlaza wepancreatic zibandakanya i-jaundice, iintlungu, kunye nokwehla kobunzima.

Umhlaza wepancreatic awunakubangela zimpawu zokuqala okanye iimpawu. Iimpawu kunye neempawu zisenokubangelwa ngumhlaza wepancreatic okanye ngezinye iimeko. Jonga ugqirha wakho ukuba unayo nayiphi na kwezi zinto zilandelayo:

• IJaundice (ukuba tyheli kolusu kunye namhlophe ngamehlo).

• Izitulo ezikhanyayo.

• Umchamo omnyama.

• Ubuhlungu kwisisu esiphakamileyo okanye esiphakathi nasemva.

• Ukwehla kwesisindo ngaphandle kwesizathu esaziwayo.

• Ukuphelelwa ngumdla wokutya.

• Ndiziva ndidiniwe.

Umhlaza wepancreatic kunzima ukuwuchonga kwangoko.

Umhlaza wepancreatic kunzima ukufumanisa kwaye uxilonge ngezi zizathu zilandelayo:

• Akukho zimpawu zibonakalayo zibonakalayo kumanqanaba okuqala omhlaza wepancreatic.

• Iimpawu zomhlaza wepancreatic, xa zikho, zifana neempawu zezinye izifo ezininzi.

• Iipancreas zifihliwe ngasemva kwamanye amalungu anje ngesisu, ithumbu elincinci, isibindi, inyongo, udakada, kunye nemibhobho yenyongo.

Uvavanyo oluvavanya iipancreas lusetyenziselwa ukufumanisa isifo somhlaza wepancreatic.

Umhlaza wepancreatic uqhele ukufumanisa ukuba uneemvavanyo kunye neenkqubo ezenza imifanekiso yepancreas kunye nendawo ejikelezileyo. Inkqubo esetyenziselwa ukufumanisa ukuba ngaba iiseli zomhlaza zisasazekile ngaphakathi nangaphandle kwepancreas ibizwa ngokuba yistage. Uvavanyo kunye neenkqubo zokufumanisa, ukufumanisa isifo, kunye nenqanaba lomhlaza wepancreatic zihlala zenziwa ngaxeshanye. Ukucwangcisa unyango, kubalulekile ukuba wazi inqanaba lesi sifo nokuba umhlaza wepancreatic ungasuswa ngotyando.

Ezi mvavanyo zilandelayo kunye neenkqubo zinokusetyenziswa:

• Uvavanyo lomzimba kunye nembali yezempilo: Uvavanyo lomzimba ukukhangela iimpawu zempilo ngokubanzi, kubandakanya nokujonga iimpawu zesifo, ezinje ngamaqhuma okanye nayiphi na into ebonakala ingaqhelekanga. Imbali yemikhwa yempilo yesigulana kunye nezifo zangaphambili kunye nonyango ziya kuthathwa.

• Izifundo ze-chemistry yegazi: Inkqubo apho kuvavanywa khona isampulu yegazi ukulinganisa izixa zezinto ezithile, ezinjenge-bilirubin, ekhutshelwa egazini ngamalungu kunye nezicubu zomzimba. Inani elingaqhelekanga (eliphezulu okanye elisezantsi kunesiqhelo) lwento elinokuba ngumqondiso wesifo.

• Uvavanyo lokumakisha: Inkqubo apho isampuli yegazi, umchamo, okanye izicwili zijongwa ukulinganisa izixa zezinto ezithile, ezinje nge-CA 19-9, kunye ne-carcinoembryonic antigen (CEA), eyenziwe ngamalungu, izicwili, okanye iiseli zesisu emzimbeni. Izinto ezithile zinxulunyaniswa neentlobo ezithile zomhlaza xa zifunyenwe kumanqanaba anyukayo emzimbeni. Oku kubizwa ngokuba kukuphawula amathumba.

• I-MRI (imaging resonance imaging): Inkqubo esebenzisa umazibuthe, amaza erediyo kunye nekhompyuter ukwenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba. Le nkqubo ikwabizwa ngokuba yimifanekiso yenyukliya yokujonga umfanekiso (i-NMRI).

• Ukuskena i-CT (ukuskena i-CAT): Inkqubo eyenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi emzimbeni, ezithathwe kwii-engile ezahlukeneyo. Imifanekiso yenziwe yikhompyuter edityaniswe kumatshini we-x-ray. Idayi inokufakwa ngaphakathi emthanjeni okanye iginywe ukunceda amalungu okanye izicwili zibonise ngokucacileyo. Le nkqubo ikwabizwa ngokuba yicompography tomography, ikhompyuter yeTomography, okanye ikhompyuter ye-axial tomography I-spiral okanye i-helical CT scan yenza uthotho lwemifanekiso eneenkcukacha zeendawo ezingaphakathi komzimba usebenzisa umatshini we-x-ray ojonga umzimba kwindlela ejikelezayo.

• Ukuskena i-PET (positron emission tomography scan) Inkqubo yokufumana iiseli zethumba ezinobungozi emzimbeni. Inani elincinci leswekile ene-radioactive (iswekile) itofelwe emthanjeni. Iskena se-PET sijikeleza ujikeleze umzimba kwaye senze umfanekiso wendawo esetyenziswa kuyo iswekile emzimbeni. Iiseli zethumba ezinobungozi zibonakala ziqaqambile emfanekisweni kuba ziyasebenza kwaye zithatha iswekile eninzi kuneseli eziqhelekileyo. Ukuskena i-PET kunye neCT scan kunokwenziwa ngaxeshanye. Oku kubizwa ngokuba yi-PET-CT.

• I-ultrasound yesisu: Uvavanyo lwe-ultrasound olusetyenziselwa ukwenza imifanekiso engaphakathi esiswini. I-transducer ye-ultrasound icinezelwe kulusu lwesisu kwaye iqondisa amaza esandi aphezulu (i-ultrasound) kwisisu. Amaza esandi abhuqa izicwili zangaphakathi kunye namalungu kwaye enza i-echoes. I-transducer ifumana i-echoes kwaye iyithumele kwikhompyuter, esebenzisa i-echoes ukwenza imifanekiso ebizwa ngokuba yi-sonograms. Umfanekiso unokuprintwa ukuze ujongwe kamva.

• I-Endoscopic ultrasound (EUS): Inkqubo apho i-endoscope ifakwe khona emzimbeni, ngesiqhelo ngomlomo okanye ngexande. I-endoscope sisixhobo esibhityileyo, esifana netyhubhu esinokukhanya kunye nelensi yokujonga. Iprojekhthi ekupheleni kwe-endoscope isetyenziselwa ukubuyisa amaza esandi aphezulu (i-ultrasound) kwizicubu zangaphakathi okanye kwizitho kunye nokwenza i-echoes. Iingqungquthela zenza umfanekiso wezicubu zomzimba ezibizwa ngokuba yi-sonogram. Le nkqubo ikwabizwa ngokuba yi-endosonografi.

• I-Endoscopic retrograde cholangiopancreatography (ERCP): Inkqubo esetyenziselwa i-x-ray imibhobho (iityhubhu) ezithwala inyongo ukusuka kwisibindi ukuya kwi-gallbladder nakwi-gallbladder ukuya kumathumbu amancinci. Ngamanye amaxesha umhlaza wepancreatic ubangela ukuba le mibhobho inciphise kwaye ibhloke okanye icothe ukuhamba kwenyongo, ibangele i-jaundice. I-endoscope (ityhubhu ebhityileyo, ekhanyisiweyo) idlula ngomlomo, ngomqala, nakwisisu kwindawo yokuqala yamathumbu amancinci. I-catheter (ityhubhu encinci) emva koko ifakwe nge-endoscope kwimibhobho yepancreatic. Idayi itofwa nge-catheter ukuya kwimibhobho kwaye kuthathwa i-x-ray. Ukuba imibhobho ivaliwe ngethumba, ityhubhu entle inokufakwa kumbhobho ukuze uyivule. Le ityhubhu (okanye i-stent) inokushiywa endaweni yokugcina indlela ivulekile. Iisampulu zeethishu nazo zinokuthathwa.

• I-Percutaneous transhepatic cholangiography (PTC): Inkqubo esetyenziselwa i-x-ray isibindi kunye ne-bile ducts. Inaliti ebhityileyo ifakwa kulusu olungezantsi kweembambo nakwisibindi. Idayi ifakwe kwisibindi okanye kwimibhobho ye-bile kwaye i-x-ray ithathwa. Ukuba kufunyenwe ukuvaleka, ityhubhu ecekeceke, eguqukayo ebizwa ngokuba yi-stent ngamanye amaxesha ishiyeka esibindini ukuze ikhuphe inyongo emathunjini amancinci okanye kwingxowa yokuqokelela ngaphandle komzimba. Olu vavanyo lwenziwa kuphela ukuba i-ERCP ayinakwenziwa.

• I-Laparoscopy: Inkqubo yotyando yokujonga amalungu ngaphakathi kwesisu ukukhangela iimpawu zesifo. Ukucuthwa okuncinci (ukusika) kwenziwa eludongeni lwesisu kunye ne-laparoscope (ityhubhu encinci, ekhanyisiweyo) ifakwe kwenye yeendlela. I-laparoscope inokuba nesiphumo se-ultrasound ekugqibeleni ukuze ibambe amaza esandi aphuma kumalungu angaphakathi, njengepancreas. Oku kubizwa ngokuba yi-laparoscopic ultrasound. Ezinye izixhobo zinokufakwa ngendlela efanayo okanye ezinye iindlela zokwenza iinkqubo ezinje ngokuthatha iisampulu zethishu kwipancreas okanye isampulu yolwelo esiswini ukujonga umhlaza.

• Biopsy: Ukususwa kweeseli okanye izicwili ukuze zijongwe ngemicroscope ngugqirha wezilwanyana ukujonga imiqondiso yomhlaza. Zininzi iindlela zokwenza i-biopsy yomhlaza wepancreatic. Inaliti elungileyo okanye inaliti engundoqo inokufakwa kwi-pancreas ngexesha le-x-ray okanye i-ultrasound ukususa iiseli. Izicubu zisenokususwa ngexesha le-laparoscopy okanye uqhaqho ukususa ithumba.

Izinto ezithile zichaphazela ukuxela kwangaphambili (ithuba lokufumana kwakhona) kunye nokhetho lonyango.

Ukuxela kwangaphambili kunye nokhetho lonyango luxhomekeke koku kulandelayo:

• Enoba okanye akunjalo i-tumor ingasuswa ngophando.

• Isigaba somhlaza (ubungakanani besisu kunye nokuba umhlaza usasazeke ngaphandle kwepancreas ukuya kwizicubu ezikufutshane okanye kwii-lymph node okanye kwezinye iindawo emzimbeni).

• Impilo yomguli ngokubanzi.

• Nokuba umhlaza sele ufumanekile okanye ubuyile kwakhona (buyela).

Umhlaza wepancreatic unokulawulwa kuphela ukuba ufunyenwe ngaphambi kokuba usasazeke, xa unokususwa ngokupheleleyo ngoqhaqho. Ukuba umhlaza usasazekile, unyango oludlamkileyo lunokuphucula umgangatho wobomi besigulana ngokulawula iimpawu kunye nobunzima besi sifo.

Amanqanaba omhlaza wePancreatic

IINGONGOMA EZIPHAMBILI

• Uvavanyo kunye neenkqubo zokubeka umhlaza wepancreatic zihlala zenziwa ngaxeshanye noxilongo.

• Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

• Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

• La manqanaba alandelayo asetyenziselwa umhlaza wepancreatic:

• Inqanaba 0 (iCarcinoma kwiSitu)

• Inqanaba I

• Inqanaba II

• Inqanaba III

• Inqanaba IV

• La maqela alandelayo asetyenziselwa ukucwangcisa unyango:

• Umhlaza wepancreatic

• Umda womhlaza womhlaza wepancreatic

• Umhlaza wepancreatic ekuhlaleni

• Umhlaza wepancreatic umhlaza

• Umhlaza wepancreatic oqhelekileyo

Uvavanyo kunye neenkqubo zokubeka umhlaza wepancreatic zihlala zenziwa ngaxeshanye noxilongo.

Inkqubo esetyenziselwa ukufumanisa ukuba umhlaza usasazekile ngaphakathi kwepancreas okanye kwamanye amalungu omzimba kuthiwa yistage. Ulwazi oluqokelelwe kwinkqubo yokubeka inqanaba lesifo. Kubalulekile ukwazi inqanaba lesi sifo ukuze ucwangcise unyango. Iziphumo zezinye zeemvavanyo ezisetyenziselwa ukufumanisa isifo somhlaza wepancreatic zihlala zisetyenziselwa ukubeka isifo. Jonga icandelo loLwazi ngokubanzi ngolwazi oluthe kratya.

Zintathu iindlela umhlaza onwenwa ngayo emzimbeni.

Umhlaza unokusasazeka ngezicubu, inkqubo ye-lymph, kunye negazi:

• Izicubu. Umhlaza usasazeka ukusuka apho waqala ngokukhula waya kwiindawo ezikufuphi.

• Inkqubo yeLymph. Umhlaza usasazeka ukusuka apho waqala ngokungena kwinkqubo ye-lymph. Umhlaza uhamba ngemithambo ye-lymph ukuya kwamanye amalungu omzimba.

• Igazi. Umhlaza usasazeka ukusuka apho waqala ngokungena egazini. Umhlaza uhamba ngemithambo yegazi uye kwamanye amalungu omzimba.

Umhlaza unokusasazeka ukusuka apho waqala khona kwamanye amalungu omzimba.

Xa umhlaza usasazeka kwelinye ilungu lomzimba, ubizwa ngokuba yi-metastasis. Iiseli zomhlaza ziyaphuma apho ziqale khona (ithumba lokuqala) kwaye zihamba ngenkqubo ye-lymph okanye igazi.

• Inkqubo yeLymph. Umhlaza ungena kwinkqubo ye-lymph, uhamba kwiinqanawa ze-lymph, kwaye wenze i-tumor (i-metastatic tumor) kwenye indawo yomzimba.

• Igazi. Umhlaza ungena egazini, uhambe kwimithambo yegazi, kwaye wenze ithumba (metastatic tumor) kwelinye ilungu lomzimba.

I-tumor ye-metastatic yinto efanayo yomhlaza njenge-tumor yokuqala. Umzekelo, ukuba umhlaza wepancreatic usasazeka esibindini, iiseli zomhlaza esibindini ziiseli zomhlaza wepancreatic. Esi sifo ngumhlaza wepancreatic metastatic, hayi umhlaza wesibindi.

La manqanaba alandelayo asetyenziselwa umhlaza wepancreatic:

Inqanaba 0 (iCarcinoma kwiSitu)

Inqanaba 0 lomhlaza wepancreatic. Iiseli ezingaqhelekanga zifumaneka kuludwe lwepancreas. Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane.

Kwinqanaba le-0, iiseli ezingaqhelekanga zifumaneka kuludwe lwepancreas. Ezi seli zingaqhelekanga zinokuba ngumhlaza kwaye zisasazeke kwizicubu eziqhelekileyo ezikufutshane. Inqanaba 0 likwabizwa ngokuba yi-carcinoma in situ.

Inqanaba I

Inqanaba I umhlaza wepancreatic. Umhlaza ufumaneka kwi-pancreas kuphela. Kwinqanaba IA, ithumba liziisentimitha ezi-2 okanye zincinci. Kwinqanaba IB, ithumba likhulu kuneesentimitha ezi-2 kodwa alikho likhulu kuneesentimitha ezi-4.

Kwinqanaba I, umhlaza sele wenziwe kwaye ufumaneka kwi-pancreas kuphela. Inqanaba I lahlulwe ngokwamanqanaba e-IA kunye ne-IB, kuxhomekeke kubungakanani bethumba.

• Isigaba IA: I-tumor i-2 cm okanye encinci.

• Isigaba IB: I-tumor inkulu kuneesentimitha ezi-2 kodwa ayikho ngaphezu kweesentimitha ezi-4.

Inqanaba II

• Isigaba II sahlulwe sangamanqanaba IIA kunye ne-IIB, kuxhomekeka kubungakanani besisu nalapho umhlaza usasazeke khona.

Isigaba IIA: Ithumba likhulu kuneesentimitha ezi-4.

Isigaba IIA somhlaza wepancreatic. Ithumba likhulu kuneesentimitha ezi-4.

• Isigaba IIB: I-tumor nayiphi na ubukhulu kunye nomhlaza usasazeke kwi-1 ukuya kwi-3 ye-lymph nodes.

Inqanaba IIB umhlaza wepancreatic. Ithumba nabuphi na ubungakanani kwaye umhlaza usasazeke kwi-1 ukuya kwi-3 ye-lymph node ezikufutshane.

Inqanaba III

Inqanaba lesithathu lomhlaza wepancreatic. Ithumba nabuphi na ubungakanani kwaye umhlaza usasazeke (a) kwi-4 okanye nangaphezulu kwe-lymph node ezikufutshane; okanye (b) imithambo yegazi emikhulu ecaleni kwepancreas. Oku kubandakanya umthambo we-portal, umthambo oqhelekileyo we-hepatic, i-celiac axis (trunk), kunye nomthambo ophezulu we-mesenteric.

Kwinqanaba lesithathu, ithumba nabuphi na ubungakanani kwaye umhlaza usasazekile waya:

• ezine okanye nangaphezulu nkovu iindawo; okanye

• imithambo yegazi ephambili kufutshane nepancreas.

Inqanaba IV

Inqanaba IV umhlaza wepancreatic. Ithumba nabuphi na ubungakanani kwaye umhlaza unwenwele nakwezinye iindawo zomzimba, ezinje ngemiphunga, isibindi, okanye iperitoneal cavity (indawo yomzimba enamalungu amaninzi esiswini).

Kwinqanaba le-IV, ithumba nabuphi na ubungakanani kwaye umhlaza usasazekile kwamanye amalungu omzimba, anjengesibindi, imiphunga, okanye iperitoneal cavity (indawo yomzimba enamalungu amaninzi esiswini).

La maqela alandelayo asetyenziselwa ukucwangcisa unyango:

Umhlaza wepancreatic

Umhlaza wepancreatic obonakalayo unokususwa ngotyando kuba khange ukhule ube yimithambo yegazi ebalulekileyo kufutshane nethumba.

Umda womhlaza womhlaza wepancreatic

Umda womhlaza womhlaza wepancreatic okhule waba ngumthambo wegazi omkhulu okanye izicwili okanye amalungu akufutshane. Kungenzeka ukuba ususe ithumba, kodwa kukho umngcipheko omkhulu wokuba zonke iiseli zomhlaza aziyi kususwa ngotyando.

Umhlaza wepancreatic ekuhlaleni

Umhlaza wepancreatic walapha ekhaya ukhule waba kufutshane nakwiindawo ezikufuphi zee-lymph node okanye imithambo yegazi, ke utyando alunako ukuwususa ngokupheleleyo umhlaza.

Umhlaza wepancreatic umhlaza

Umhlaza wepancreatic metastatic unwenwele kwamanye amalungu, ke utyando alunakho ukuwususa ngokupheleleyo umhlaza.

Umhlaza wepancreatic oqhelekileyo

Umhlaza wepancreatic oqhelekileyo uphinde wabuya (ubuye) emva kokuba unyangiwe. Umhlaza ungabuya kwi-pancreas okanye kwamanye amalungu omzimba.

Unyango ngoKhetho lonyango

IINGONGOMA EZIPHAMBILI

• Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza wepancreatic.

• Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

• Ugqirha

• Unyango ngemitha

• Unyango ngamayeza

• Unyango lweChemoradiation

• Unyango ekujoliswe kulo

• Kukho unyango lwentlungu ebangelwa ngumhlaza wepancreatic.

• Izigulana ezinomhlaza wepancreatic zineemfuno ezizodwa zesondlo.

• Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

• Unyango lomhlaza wepancreatic lunokubangela iziphumo ebezingalindelekanga.

• Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

• Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

• Iimvavanyo zokulandelela zisenokufuneka.

Kukho iintlobo ezahlukeneyo zonyango kwizigulana ezinomhlaza wepancreatic.

Iindidi ezahlukeneyo zonyango ziyafumaneka kwizigulana ezinomhlaza wepancreatic. Olunye unyango lusemgangathweni (unyango olusetyenziswayo ngoku), kwaye olunye luvavanywa kuvavanyo lweklinikhi. Uvavanyo lweklinikhi yonyango luphononongo olwenzelwe ukunceda ukuphucula unyango lwangoku okanye ukufumana ulwazi kunyango olutsha kwizigulana ezinomhlaza. Xa uvavanyo lwezonyango lubonisa ukuba unyango olutsha lungcono kunonyango oluqhelekileyo, unyango olutsha kunokuba lunyango olusemgangathweni. Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi. Olunye uvavanyo lwezonyango luvuleleke kuphela kwizigulana ezingaluqalanga unyango.

Iindidi ezintlanu zonyango olusetyenziswayo zisetyenziswa:

Ugqirha

Enye yezi ndlela zilandelayo yotyando inokusetyenziselwa ukukhupha ithumba:

• Inkqubo yeWhipple: Inkqubo yotyando apho intloko yepancreas, inyongo, inxenye yesisu, inxenye yamathumbu amancinci, kunye nomgudu wenyongo. Kwanele ipancreas kushiyeka ukuvelisa incindi yokwetyisa kunye ne-insulin.

• I-pancreatectomy iyonke: Lo msebenzi ususa yonke i-pancreas, inxalenye yesisu, inxalenye yesisu esincinci, i-bile ye-bile, i-gallbladder, i-spleen kunye ne-lymph nodes ezikufutshane.

• Ipancreatectomy esekude: Utyando lokususa umzimba kunye nomsila wepancreas. I-spleen ingasuswa kwakhona ukuba umhlaza usasazeke kwipeni.

Ukuba umhlaza usasazekile kwaye awunakususwa, ezi ntlobo zilandelayo zotyando lwenzuzo zinokwenziwa ukunciphisa iimpawu kunye nokuphucula umgangatho wobomi:

• I-Biliary bypass: Ukuba umhlaza uvimba i-bile duct kwaye i-bile iyakha kwi-gallbladder, i-biliary byass ingenziwa. Ngexesha lotyando, ugqirha uya kusika i-gallbladder okanye i-bile duct kuloo ndawo ngaphambi kokuvaleka kwaye ayithungele kumathumbu amancinci ukwenza indlela entsha ejikeleze indawo evaliweyo.

• Ukufakwa kwe-Endoscopic stent: Ukuba i-tumor ivimbela i-bile duct, utyando lunokwenziwa ukubeka i-stent (ityhubhu encinci) ukukhupha i-bile eyakhiwe kuloo ndawo. Ugqirha unokubeka i-stent ngokusebenzisa i-catheter ekhupha i-bile kwisikhwama ngaphandle komzimba okanye i-stent inokujikeleza indawo evaliweyo kwaye ikhuphe i-bile emathunjini amancinci.

• Ukudlula esiswini: Ukuba ithumba ibhloka ukuphuma kokutya esiswini, isisu sinokuthungwa ngokuthe ngqo kumathumbu amancinci ukuze isiguli siqhubeke nokutya ngesiqhelo.

Unyango ngemitha

Unyango ngemitha lunyango olusebenzisa amandla e-x-reyi okanye ezinye iintlobo zemitha yokubulala iiseli zomhlaza okanye ukuzigcina zikhula. Unyango lwangaphandle lwemitha lusebenzisa umatshini ongaphandle komzimba ukuthumela imitha kwindawo yomzimba enomhlaza.

Unyango ngamayeza

I-Chemotherapy yonyango lomhlaza olusebenzisa iziyobisi ukunqanda ukukhula kweeseli zomhlaza, nokuba zibulale iiseli okanye uziyekise ekwahlukaneni. Xa i-chemotherapy ithathwa ngomlomo okanye ifakwe kwi-vein okanye kwimisipha, amachiza angena kwigazi kwaye anokufikelela kwiiseli zomhlaza kuwo wonke umzimba (systemic chemotherapy). Umdibaniso wekhemotherapy yonyango olusebenzisa ngaphezulu kwesiyobisi esinye somhlaza.

Jonga iziyobisi ezivunyiweyo zomhlaza wepancreatic ngolwazi oluthe kratya.

Unyango lweChemoradiation

Unyango lwe-Chemoradiation ludibanisa i-chemotherapy kunye nonyango lwemitha ukunyusa iziphumo zazo zombini.

Unyango ekujoliswe kulo

Unyango ekujoliswe kulo luhlobo lonyango olusebenzisa iziyobisi okanye ezinye izinto ukuchonga nokuhlasela iiseli ezithile zomhlaza. Unyango ekujoliswe kulo kunokubangela ingozi encinci kwiiseli eziqhelekileyo kunonyango lwechemotherapy okanye unyango lwemitha. I-Tyrosine kinase inhibitors (i-TKIs) zijolise kunyango lwamachiza athintela imiqondiso efunekayo ukuze kukhule amathumba. I-Erlotinib luhlobo lwe-TKI olusetyenziselwa ukunyanga umhlaza wepancreatic.

Jonga iziyobisi ezivunyiweyo zomhlaza wepancreatic ngolwazi oluthe kratya.

Kukho unyango lwentlungu ebangelwa ngumhlaza wepancreatic.

Ubuhlungu bunokwenzeka xa ithumba licinezela kwimithambo-luvo okanye kwamanye amalungu akufutshane nepancreas. Xa iyeza leentlungu alonelanga, kukho unyango olusebenza kwimithambo-luvo esiswini ukukhupha iintlungu. Ugqirha unokufaka iyeza kwindawo ejikeleze imithambo-luvo echaphazelekayo okanye asike imithambo-luvo ukubamba uvakalelo lwentlungu. Unyango lwe-radiation kunye okanye ngaphandle kwe-chemotherapy lunokunceda ekuthomalaliseni iintlungu ngokunciphisa ithumba. Jonga isishwankathelo se kubuhlungu bomhlaza ngolwazi oluthe kratya.

Izigulana ezinomhlaza wepancreatic zineemfuno ezizodwa zesondlo.

Utyando lokususa i-pancreas lunokuchaphazela amandla alo okwenza ii-enzyme zepancreatic ezinceda ukwetyisa ukutya. Ngenxa yoko, abaguli banokuba nengxaki yokwetyisa ukutya kunye nokufunxa izondlo emzimbeni. Ukuthintela ukungondleki, ugqirha unokuyalela amayeza athatha indawo yezi enzymes. Jonga isishwankathelo se- malunga nesondlo kukhathalelo lomhlaza ngolwazi oluthe kratya.

Iindidi ezintsha zonyango ziyavavanywa kuvavanyo lweklinikhi.

Eli candelo lesishwankathelo lichaza unyango olufundwayo kuvavanyo lweklinikhi. Isenokungakhankanyi lonke unyango olutsha olufundwayo. Ulwazi malunga novavanyo lweklinikhi luyafumaneka kwiwebhusayithi yeNCI.

Unyango lomhlaza wepancreatic lunokubangela iziphumo ebezingalindelekanga.

Ngolwazi malunga neziphumo ebezingalindelekanga ezibangelwa lunyango lomhlaza, jonga iphepha lethu Iziphumo ezingalunganga.

Izigulana zinokufuna ukucinga ngokuthatha inxaxheba kuvavanyo lweklinikhi.

Kwezinye izigulana, ukuthatha inxaxheba kuvavanyo lweklinikhi kunokuba lolona khetho lonyango lufanelekileyo. Uvavanyo lwezonyango luyinxalenye yenkqubo yophando ngomhlaza. Uvavanyo lwezonyango luyenziwa ukufumanisa ukuba unyango lomhlaza olutsha lukhuselekile kwaye luyasebenza okanye lungcono kunonyango oluqhelekileyo.

Uninzi lonyango oluqhelekileyo lwanamhlanje lomhlaza lusekwe kuvavanyo lweklinikhi lwangaphambili. Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zingafumana unyango olusemgangathweni okanye zibe phakathi kwabokuqala ukufumana unyango olutsha.

Izigulana ezithatha inxaxheba kuvavanyo lweklinikhi zikwanceda ukuphucula indlela umhlaza oza kunyangwa ngayo kwixa elizayo. Nokuba uvavanyo lwezonyango alukhokeleli kunyango olusebenzayo, bahlala bephendula imibuzo ebalulekileyo kwaye bancedisa ukuqhubela phambili uphando.

Izigulana zinokungena kuvavanyo lweklinikhi ngaphambi, ngexesha, okanye emva kokuqala unyango lomhlaza.

Olunye uvavanyo lwezonyango lubandakanya kuphela izigulana ezingekafumani unyango. Olunye uvavanyo lokuvavanywa kunyango kwizigulana ezinomhlaza ongakhange ubengcono. Kukwakho nezilingo zeklinikhi ezivavanya iindlela ezintsha zokumisa umhlaza ekubuyeleni (ekubuyeni) okanye ukunciphisa iziphumo ebezingalindelekanga zonyango lomhlaza.

Uvavanyo lwezonyango lwenzeka kwiindawo ezininzi zelizwe. Ulwazi malunga novavanyo lweklinikhi oluxhaswe yi-NCI lunokufumaneka kwiphepha lewebhu le-NCI. Uvavanyo lwezonyango oluxhaswa yiminye imibutho lunokufumaneka kwiwebhusayithi yeClinicalTrials.gov.

Iimvavanyo zokulandelela zisenokufuneka.

Ezinye zeemvavanyo ezenziweyo ukufumanisa umhlaza okanye ukufumanisa inqanaba lomhlaza zinokuphindwa. Olunye uvavanyo luya kuphindwa ukuze kubonwe ukuba lusebenza njani unyango. Izigqibo malunga nokuqhubeka, ukutshintsha, okanye ukuyeka unyango zinokusekwa kwiziphumo zolu vavanyo.

Ezinye zeemvavanyo ziya kuqhubeka ukwenziwa amaxesha ngamaxesha emva kokuba unyango luphelile. Iziphumo zolu vavanyo zingabonisa ukuba imeko yakho itshintshile okanye ukuba umhlaza ubuyile (buyela). Olu vavanyo ngamanye amaxesha lubizwa ngokuba luvavanyo olulandelayo okanye ukuhlolwa.

Unyango lweCancer ePancreatic ebonakalayo

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lomhlaza wepancreatic onokuthi uphinde uhlawulwe umda unokubandakanya oku kulandelayo:

• I-Chemotherapy kunye okanye ngaphandle kwonyango lwe-radiation olulandelayo luhlinzwa.

• Ugqirha.

• Utyando olulandelwa yichemotherapy.

• Utyando olulandelwa yikhemoradiation.

• Uvavanyo lweklinikhi lwe-chemotherapy kunye / okanye unyango lwe-radiation ngaphambi kotyando.

• Uvavanyo lweklinikhi ngeendlela ezahlukeneyo zokunika unyango ngemitha.

Utyando lokususa ithumba lunokubandakanya inkqubo yeWhipple, iyonke i-pancreatectomy, okanye i-distal pancreatectomy.

Unyango lokuthambisa lunokuqalwa nakweliphi na inqanaba lesifo. Jonga icandelo lePalliative Therapy ngolwazi malunga nonyango olunokuphucula umgangatho wobomi okanye linciphise iimpawu kwizigulana ezinomhlaza wepancreatic.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango lweCancer ePancreatic yaseKhaya

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lomhlaza wepancreatic oqhubela phambili ekuhlaleni unokubandakanya oku kulandelayo:

• I-Chemotherapy kunye okanye ngaphandle kwonyango ekujoliswe kulo.

• I-Chemotherapy kunye ne-chemoradiation.

• Utyando (Inkqubo yeWhipple, iyonke i-pancreatectomy, okanye i-distre pancreatectomy).

• Utyando lokunyanga okanye ukubekwa kwesitendi ukudlula kwiindawo ezivaliweyo kwimibhobho okanye emathunjini amancinci. Abanye abaguli banokufumana ichemotherapy kunye nechemoradiation yokunciphisa ithumba ukuvumela ukuba kwenziwe utyando.

• Uvavanyo lweklinikhi yonyango olutsha lwe-anticancer kunye ne-chemotherapy okanye i-chemoradiation.

• Uvavanyo lweklinikhi yonyango lwemitha olunikezwe ngexesha lotyando okanye unyango lwangaphakathi lwemitha.

Unyango lokuthambisa lunokuqalwa nakweliphi na inqanaba lesifo. Jonga icandelo lePalliative Therapy ngolwazi malunga nonyango olunokuphucula umgangatho wobomi okanye linciphise iimpawu kwizigulana ezinomhlaza wepancreatic.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango lweCancer Metastatic okanye iParcreatic Cancer

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lomhlaza wepancreatic oluye lwasasazeka kwakhona okanye lwaphinda lwenzeka kunokubandakanya oku kulandelayo:

• I-Chemotherapy kunye okanye ngaphandle kwonyango ekujoliswe kulo.

• Uvavanyo lwezonyango lweearhente ezintsha zomhlaza kunye okanye ngaphandle kwonyango.

Unyango lokuthambisa lunokuqalwa nakweliphi na inqanaba lesifo. Jonga icandelo lePalliative Therapy ngolwazi malunga nonyango olunokuphucula umgangatho wobomi okanye linciphise iimpawu kwizigulana ezinomhlaza wepancreatic.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Unyango lokunyanga

Ngolwazi malunga nonyango oludweliswe ngezantsi, jonga kwiCandelo loKhetho ngokujonga uKhetho.

Unyango lwe-Palliative lunokuphucula umgangatho wobomi besigulana ngokulawula iimpawu kunye neengxaki zomhlaza wepancreatic.

Unyango lokunyanga umhlaza wepancreatic lubandakanya oku kulandelayo:

• Utyando lokunyanga okanye ukubekwa kwesitendi ukudlula kwiindawo ezivaliweyo kwimibhobho okanye emathunjini amancinci.

• Unyango lwe-radiation yokunyanga ukunceda ukunciphisa iintlungu ngokunciphisa ithumba.

• Inaliti yeyeza ukunceda ukudambisa iintlungu ngokuthintela imithambo-luvo esiswini.

• Olunye unyango lwezonyango lodwa.

Sebenzisa uvavanyo lwethu lweklinikhi ukufumana ulingo lweklinikhi oluxhaswayo lwekliniki olwamkela izigulana. Unokukhangela izilingo ngokusekwe kuhlobo lomhlaza, ubudala besigulana, kwaye nokuba zenziwa phi izilingo. Ulwazi ngokubanzi malunga novavanyo lweklinikhi luyafumaneka.

Ukufunda ngakumbi malunga noMhlaza wePancreatic

Ngolwazi oluthe kratya kwiZiko leSizwe loMhlaza malunga nomhlaza wepancreatic, bona oku kulandelayo:

• Iphepha leKhaya laseKhaya loMhlaza

• Unyango lweCancreatic Cancer

• Iziyobisi ezivunyiweyo zomhlaza wepancreatic

• Iithagethi zoMhlaza ezijolise kuko

Ngolwazi lomhlaza ngokubanzi kunye nezinye izixhobo ezivela kwiNational Cancer Institute, jonga oku kulandelayo:

• Malunga noMhlaza

• Ukuqokelela

• I-Chemotherapy kunye nawe: Inkxaso yabantu abanomdlavuza

• Unyango ngemitha kunye nawe: Inkxaso yabantu abanomhlaza

• Ukujamelana noMhlaza

• Imibuzo yokubuza ugqirha wakho malunga neCancer

• Abasindileyo kunye nabaNonopheli

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